THE EFFECT OF ORTHOSTATIC HYPOTENSION ON CEREBRAL BLOOD-FLOW AND MIDDLE CEREBRAL-ARTERY VELOCITY IN AUTONOMIC FAILURE, WITH OBSERVATIONS ON THE ACTION OF EPHEDRINE
THE EFFECT OF ORTHOSTATIC HYPOTENSION ON CEREBRAL BLOOD-FLOW AND MIDDLE CEREBRAL-ARTERY VELOCITY IN AUTONOMIC FAILURE, WITH OBSERVATIONS ON THE ACTION OF EPHEDRINE
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DOI：
10.1136/jnnp.52.8.962
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发表时间：
1989-08-01
影响因子：
11
通讯作者：
SYMON, L
中科院分区：
文献类型：
--
作者：
BROOKS, DJ;REDMOND, S;SYMON, L
应用133 Xe冲洗法和经颅多普勒超声对10例植物神经功能衰竭患者的脑血流（CBF）和大脑中动脉血流速度（MCAv）进行了测定。4例单纯自主神经功能衰竭和4例多系统萎缩患者的表现相似;将其倾斜至足以引起显著的直立性低血压而不引起晕厥症状，导致其平均MCAv显著下降，但其平均CBF无变化。这些结果表明，脑自动调节在自主神经功能衰竭、体位性低血压导致反应性血管舒张（降低MCAv、降低血管阻力并维持CBF）时得以保留。麻黄素对直立性低血压有纠正作用，但对脑血流量无直接影响。两个兄弟姐妹患有继发于多巴胺-β的直立性低血压，羟化酶缺乏也保留了脑自动调节功能，但麻黄素导致这些患者反常性低血压。
Cerebral blood flow (CBF) and middle cerebral artery velocity (MCAv) have been measured using 133xenon washout and transcranial Doppler in ten patients with autonomic failure. Four pure autonomic failure and four multiple system atrophy patients behaved similarly; tilting them sufficiently to induce significant orthostatic hypotension without causing syncopal symptoms led to a significant fall in their mean MCAv, but no change in their mean CBF. These findings suggest that cerebral autoregulation is preserved in autonomic failure, orthostatic hypotension resulting in a reactive vasodilatation which lowers MCAv, reduces vascular resistance, and maintains CBF. Ephedrine helped to correct the orthostatic hypotension, but had no direct effect on CBF. Two siblings with orthostatic hypotension secondary to dopamine-.beta.-hydroxylase deficiency also had preserved cerebral autoregulation, but ephedrine led to paradoxical hypotension in these patients.